Dentrix Ascend vs Open Dental

PickMyPMS Editorial · Last reviewed Sep 28, 2026

Quick verdict

Open Dental suits a practice that wants a published price list, a contract that drops to month-to-month after the first year, and a database it can see and back up directly. Dentrix Ascend suits a practice that wants a hosted subscription with no server to buy, needs to run on Macs or iPads, or is planning to add locations under one of Henry Schein One’s packaged tiers.

Open Dental does sell a hosted version, Open Dental Cloud, but the product page describes it as a limited release rather than the default way to buy. Most Open Dental offices still run the desktop version on their own server.

Your own server or a hosted subscription

Open Dental is Windows software. The published system requirements list Windows workstations, and the practice’s own server holds the MySQL database. Buying, patching and backing up that server is the practice’s job, or its IT company’s.

Dentrix Ascend runs in a browser on Windows or macOS computers, or on an iPad. Henry Schein One hosts the application and the database, so there is no office server to maintain.

That split shows up in the price lists, too. Open Dental’s fee schedule is public. Henry Schein One publishes no price for Ascend at all, so anyone shopping Ascend is working from a quote, not a list.

What each costs

Open Dental’s support fee is $149 a month per location after the first 12 months, and it covers up to three dentists. New customers pay an introductory $199 for that first year, a rate that rose from $179 on February 2, 2026. Each dentist past the first three costs an additional $20 monthly. An optional eServices bundle runs $165 per location, and texting is billed separately: $5 for an assigned number or $20 for a landline number, both monthly, plus $0.04 per message sent in the US.

Open Dental also sells a hosted plan, Open Dental Cloud (currently in limited release), starting at $430 a month per location for one provider, with additional providers at $150 a month and a one-time $400 migration fee. That is a separate product from the self-hosted price above, not something to add to it.

Henry Schein One publishes no price for Dentrix Ascend. One pricing site lists $4,788 a year for a single user, with the same page showing $9,588 a year for 10 users and $19,188 a year for 100 users. A second site estimates $500 to $1,200 a month. Neither source explains how it arrived at those figures, so use them only to open a quote conversation with a sales rep.

When you compare real numbers from both vendors, run them through our cost calculator to see five-year totals side by side, including Open Dental’s per-provider scaling and any setup costs.

Contracts and cancelling

Open Dental starts with a 12-month term and then converts to month-to-month, so after the first year there is no renewal date to track. The company also backs its support fee with a 90-day money-back guarantee.

Dentrix Ascend starts with a 12-month term and renews for further 12-month terms at whatever fees are in effect at renewal. Henry Schein One can change those fees with notice by email or an in-product announcement. Leaving requires written notice of non-renewal at least 60 days before the term ends. Cancel early and you can owe the rest of the term, with no refund of fees already paid.

If you sign with Ascend, put the 60-day notice window in your calendar at least 90 days ahead. Open Dental’s month-to-month terms remove that clock after year one.

Getting your data out

Open Dental’s database is MySQL and lives on the practice’s own server from day one, so there is no vendor process to request when you leave. You already hold the files; moving them into a different system is still a conversion job.

Under the Ascend terms, when the agreement ends you can request read-only access and a copy of your data in SQL database format. Data you have not requested within 90 days can be deleted, and extending read-only access past that point costs extra. Request the export before the term ends rather than after.

Switching between the two

Moving data into Open Dental from another system costs $1,450 per database, plus $900 for X-rays, $850 for documents and $400 for each additional clinic. Those are published figures, so you can budget for them before you sign.

Henry Schein One does not publish a comparable conversion price or process for data moving into Ascend. Ascend reviewers on Capterra describe slow insurance setup and data conversion, which is worth raising directly with a sales rep rather than assuming it will go smoothly.

Before you sign with either vendor, get written answers to:

• The full conversion cost, including images and documents, not just the base database fee.
• Which records convert: patient history, ledger, insurance plans, clinical notes and perio charts.
• How long any existing contract still runs, so you are not paying two vendors during the switch.
• What training is included, since insurance setup is where Ascend reviewers report the most friction.

Imaging and features

Dentrix Ascend includes imaging for 2D, 3D CBCT and CAD/CAM as part of the product, with no separate fee cited by Henry Schein One. Its Essentials package includes payments, claims processing, patient booking, and text and email messaging; Pro adds Eligibility Pro checks and multi-location management; Accelerate adds enterprise reporting. Orthodontic workflows, Voice Perio and an expanded Eligibility Pro arrived in June 2026.

We found no published statement of Open Dental’s built-in imaging capability to cite here. Its pricing does show that texting is billed as an add-on, at $5 to $20 a month plus per-message fees, rather than bundled into the base support price. We could not confirm from the data whether Open Dental includes eligibility checks, claims submission or online scheduling in the base price; ask for that in writing if those matter to your workflow.

On review sites, Open Dental holds 4.6 out of 5 from 89 Capterra reviews, and reviewers there cite published pricing and no long-term contract after the first year as strengths, against a learning curve, a dated interface and paying for live support as complaints. Dentrix Ascend holds 4.1 from 235 reviews, with reviewers praising multi-location management, remote access without a server and an easy interface, and complaining about confusing reporting and long waits for support.

Who should pick which

Pick Open Dental if you:

• Want a published price list you can compare in writing before you call sales.
• Are fine running Windows workstations and want the database on your own server.
• Want the contract to drop to month-to-month after the first year.

Pick Dentrix Ascend if you:

• Want to stop buying and maintaining an office server.
• Use Macs or iPads, or want staff to work from home.
• Are running, or planning to run, more than one location.

If neither description fits cleanly, the Find my PMS quiz scores both products, and other options, against your specialty, size and budget.